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The American College of Cardiology (ACC) and the American Board of Internal Medicine (ABIM) announced on March 15 an alternative option for cardiologists to maintain their board certification. The Collaborative Maintenance Pathway (CMP) will feature an annual performance assessment, each covering about 20 percent of the field of cardiovascular disease, so the entire span of general cardiology can be covered in five years.

ABIM’s traditional maintenance of certification (MOC) exam—taken once every 10 years—as well as the two-year Knowledge Check-in exams will remain available to those who don’t participate in the new pathway, according to the ACC.

"The new CMP leverages the respective expertise of the ACC and ABIM to create a literal 'pathway' that meets the ongoing learning needs of cardiologists, while also giving patients, the public and other stakeholders confidence that the care provided by their physicians is of the highest quality," ACC CEO Timothy W. Attebery, DSc, MBA, said in a press release. "We appreciate ABIM working with us on what we believe is a win-win solution for cardiologists and the patients they serve."

Physicians from multiple specialties have taken aim at MOC practices in recent months. A group of internists filed a class-action lawsuit against the ABIM in December, alleging the ABIM had created a monopoly for MOC by “illegally tying its initial certification product to its maintenance of certification product.” The complaint also stated the ABIM has used anti-competitive and unlawful actions to maintain the monopoly and “charged inflated monopoly prices for MOC.”

On Feb. 26, a Tennessee radiologist filed a similar class-action lawsuit against the American Board of Radiology, also alleging illegal ties between the ABR’s initial certifications and MOC program.

In a statement responding to the December lawsuit, the ABIM said it would “vigorously defend itself, recognizing that doing so will consume resources far better dedicated to continuous improvement of its programs.” The statement also pointed to the recent implementation of the Knowledge Check-in option and mentioned its ongoing discussions with the ACC and other specialty societies for alternative MOC pathways.

The Cardiovascular Disease CMP, which will begin with its first assessment this fall, will use the ACC’s Adult Clinical Cardiology Self-Assessment Program (ACCSAP). The 2019 test will cover arrhythmias, while assessment pathways for cardiac electrophysiology, interventional cardiology, advanced heart failure and transplant cardiology are expected to be available in 2020, according to the release.

Each year, cardiologists will be required to engage in ACCSAP educational materials on those particular topics to qualify for the performance assessments later that year. Physicians will have two chances to pass each assessment.

ACCSAP will remain as a standalone continuing medical education program for physicians regardless of their participation in the ABIM MOC, the ACC said.

"Through meaningful engagement with the physician community and professional societies, ABIM is proud to continue the evolution of our MOC program in a myriad of ways to better meet the needs of physicians and the patients they serve," Richard J. Baron, MD, president and CEO of ABIM, said in the release.

"This new offering increases choice, flexibility and relevance for board certified cardiologists while also keeping a performance standard that gives patients confidence that their physician possesses the current medical knowledge necessary to deliver high-quality care. We appreciate ACC's expertise and partnership throughout this journey to co-create an innovative new assessment option for cardiologists."